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NPI Code Detail

MEDICARE: CHELSEA LEE MOORE RD, CD

MEDICARE: CHELSEA LEE MOORE RD, CD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianDI.60411675WA

General Provider Information

NPI Number : 1528494606
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEA LEE MOORE RD, CD
Provider Business Mailing Address
First Line : 7440 4TH AVE NE
Second Line :
City : SEATTLE
State : WA
Zip : 98115-5324
Country : US
Telephone Number : 425-890-5681
Fax Number :
Provider Business Practice Location Address
First Line : 4030 ALDERWOOD MALL BLVD
Second Line :
City : LYNNWOOD
State : WA
Zip : 98036-6763
Country : US
Telephone Number : 425-776-0803
Fax Number : 425-776-0813
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2013
Last Update Date : 02/14/2017

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Directions to “ CHELSEA LEE MOORE RD, CD” Practice Location

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